Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"Change in perception of non-operated body areas after abdominoplasty in massive weight loss patients – A prospective multicenter study","authors":"Jakub Opyrchal ,&nbsp;Anne van Beek ,&nbsp;Maarten Hoogbergen ,&nbsp;Lisa van den Berg ,&nbsp;Julie Verkaar ,&nbsp;Marek Paul","doi":"10.1016/j.bjps.2025.05.005","DOIUrl":"10.1016/j.bjps.2025.05.005","url":null,"abstract":"<div><div>As obesity becomes more prevalent worldwide, the demand for obesity-related treatments, including bariatric surgeries and Body Contouring Surgery (BCS) has surged<strong>.</strong> While bariatric surgery effectively induces weight loss, most patients are left with excess skin<strong>.</strong> As a result, the demand for BCS has steadily increased. Studies consistently report improvements in Health-Related Quality of Life (HRQoL) and body satisfaction of the operated areas after body contouring surgery. However, little research has investigated how BCS affects the perception of untreated body areas.</div><div>A total of 241 patients were enrolled in the prospective study, 144 (34% Polish, 66% Dutch) completed the BODY-Q questionnaire preoperatively and one year postoperatively. The Total Weight Loss (TWL) before BCS was 40.3% (SD ± 9.1). Our results show that body contouring surgery positively impacts both satisfaction with surgically treated areas and overall HRQoL. The indirect body area scales demonstrated significant improvements in all non-operated body areas, except for inner thigh satisfaction, which did not reach significance at twelve months (p=0.09).</div><div>In conclusion, this study shows that a single body contouring procedure after massive weight loss can significantly improve patients' perception of their entire body, enhancing whole body image and health-related quality of life.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 108-113"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144098871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The anatomical sequence of arterial calcification in peripheral vascular disease and its implications for free flap reconstruction","authors":"John M. Felder ,&nbsp;Kenan Tawaklna ,&nbsp;Emmanuel Nageeb ,&nbsp;Patrick Geraghty","doi":"10.1016/j.bjps.2025.05.004","DOIUrl":"10.1016/j.bjps.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Lower extremity (LE) free tissue transfer (FTT) in patients with peripheral vascular disease (PVD) is complicated by arterial calcification, which may occur in free flap pedicle vessels as well as recipient vessels. However, no studies have examined the likelihood of encountering calcification in common flap pedicles or the anatomical sequence in which this process occurs.</div></div><div><h3>Methods</h3><div>Computed tomography (CT) and x-ray (XR) imaging were obtained in PVD patients undergoing LE FTT. Using software designed for cardiac vessel calcium analysis, calcium volume was quantified in flap pedicles of the trunk, upper extremity, pelvis, and lower extremity on CT images. Descriptive statistics were used to identify flap vessels most affected by calcification. A novel scoring system (Qual Calc) was developed to predict the likelihood of flap pedicle calcification by examining the qualitative presence of vascular calcification on plain foot XR.</div></div><div><h3>Results</h3><div>Trunk pedicles (subscapular) showed statistically significantly lower calcification rates and volumes than lower extremity pedicles. LE flap pedicles were most likely to be calcified, with the lateral femoral circumflex artery being the most frequently calcified. Qual Calc score was highly predictive of quantified calcium volume in workhorse flaps of the upper and lower extremity.</div></div><div><h3>Conclusion</h3><div>Arterial calcification proceeds anatomically from the lower extremity cephalad towards the chest. Flaps based on the subscapular system are least affected by calcification and represent a safer reconstructive choice than thigh-based flaps for limb salvage in vasculopathic patients. Simple foot x-rays can be used to predict flap pedicle calcification with a reasonable degree of accuracy.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 148-155"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient involvement in pre-surgical triaging for non-melanoma skin cancer: A feasibility study","authors":"Vibeke Koudahl ,&nbsp;Anne Sofie Krogh Holdam ,&nbsp;Hans B. Rahr ,&nbsp;Bekka Christensen","doi":"10.1016/j.bjps.2025.05.012","DOIUrl":"10.1016/j.bjps.2025.05.012","url":null,"abstract":"<div><div>The rising incidence of non-melanoma skin cancer (NMSC) calls for innovation to manage the disease, given its significant morbidity and associated costs. Effective triaging is crucial to optimize patient pathways and reduce hospital visits. This study investigated whether pre-surgical triage could be improved by inviting patients with NMSC to capture and submit two photographs of their skin lesions and completing a questionnaire using a mobile application called ‘Mit Sygehus’, which is an integrated part of the patients’ electronic medical record.</div><div>Our study employed a mixed-methods approach to evaluate the practicality and patient experience with the application. Three patients participated in a workshop where they successfully used the ‘Mit Sygehus’ application and provided valuable feedback that led to refinements in the process. A pilot study was conducted, inviting 55 eligible patients, with 27 responding. Of these, 18 were triaged directly to surgical treatment and avoided a visit in the outpatient clinic. Interviews with 15 patients who did not accept the invitation revealed technical difficulties as the primary barrier, despite a willingness to participate. A subset of patients preferred traditional consultations due to advanced age and uncertainty as to the use of the new technology.</div><div>In conclusion, incorporating patient-submitted photographs into the pre-surgical planning process for NMSC appears promising for optimizing patient triage.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 62-65"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The United Kingdom Hand and Upper Limb Transplantation Service: A report on the first twelve years of a single-center, single-protocol clinical cohort","authors":"David A. Leonard ,&nbsp;Ibrahim Natalwala ,&nbsp;Sarah Taplin ,&nbsp;Joanna Burdon ,&nbsp;Emily L. Clarke ,&nbsp;Adrienne Seitz ,&nbsp;Will Merchant ,&nbsp;Daniel J. Wilks ,&nbsp;Brendan Clark ,&nbsp;Maggie Bellew ,&nbsp;Richard J. Baker ,&nbsp;Grainne Bourke ,&nbsp;Simon PJ Kay","doi":"10.1016/j.bjps.2025.05.001","DOIUrl":"10.1016/j.bjps.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Following the world’s first case (1998), proof of concept was established for hand and upper limb transplantation (HAUL-T). By 2012, there was sufficient evidence for the United Kingdom HAUL-T service to be established on a standard of care basis. A commitment was made to report in detail on this prospective, single-center, single-protocol series. We provide the first comprehensive report on the procedures, surgical, functional, immunological and psychosocial outcomes of the United Kingdom (UK) HAUL-T service.</div></div><div><h3>Methods</h3><div>Potentially suitable patients undergo sequential psychological and immunological evaluation over one year. Immunosuppression is induced with alemtuzumab, and maintained with tacrolimus, mycophenolate mofetil and prednisolone. Surgical techniques vary with the level of amputation. Rejection monitoring is clinical, with biopsy when indicated. Psychological follow-up is routine, immunosuppression monitoring and hand therapy delivery are shared with the teams local to the recipient.</div><div>Annual review in Leeds includes SF-36 and patient satisfaction questionnaires, a suite of functional outcome measures, measurement of grip and pinch strength, Semmes-Weinstein monofilament testing, Sollerman Hand Function, and Box &amp; Blocks Tests.</div></div><div><h3>Results</h3><div>Ten patients have received 17 transplanted limbs, with follow-up between 6 months and 11 years. Graft survival is 100%. Five patients have produced donor-specific antibodies (DSA). All report overall psychosocial benefit. All demonstrate sensory and motor recovery at least sufficient for functional integration. Six patients have more than 4 years of follow-up, of which 4 demonstrate clinically significant improvements in composite functional scores. Nine have undergone secondary surgery. Post-transplant renal impairment is significantly more severe in patients with a prior history of dialysis.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 331-341"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144212520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic review and meta-analysis of mobilisation following open reduction and internal fixation of hand fractures","authors":"Jacinta Kynaston ,&nbsp;Jun Jonathan Yang ,&nbsp;Conrad Harrison ,&nbsp;Anne Alexander ,&nbsp;Kat Steiner ,&nbsp;Sarah Tucker ,&nbsp;Justin Wormald","doi":"10.1016/j.bjps.2025.05.006","DOIUrl":"10.1016/j.bjps.2025.05.006","url":null,"abstract":"<div><div>Delayed mobilisation following open reduction and internal fixation (ORIF) of hand fractures may contribute to stiffness and poor functional recovery. The aim of this systematic review and meta-analysis was to evaluate whether timing of mobilisation post-ORIF impacts patient-reported and clinical post-operative outcomes.</div><div>The review was conducted according to the Cochrane Handbook and was reported in concordance with PRISMA guidelines. All studies reporting mobilisation regimens following ORIF performed within two weeks of metacarpal or phalangeal fractures were included. Of 794 abstracts screened, 53 studies were included, evaluating 1822 hand fractures treated with ORIF.</div><div>We found differences between mobilisation timing in patient-reported outcome measures (PROMs), adverse events and time to radiological fracture union. Immediate mobilisation (≤1 day of ORIF) had the shortest mean bone healing time of 38.7 days (95% CI 34.3, 42.3) compared to early mobilisation (≤7 days) (49.6 days [95% CI 42.8, 56.5]). Delayed mobilisation (&gt;7 days) had the lowest rate of adverse events at 9.3% [95% CI 5.6, 15.2] compared to early mobilisation at 25.0% [95% CI 17.1, 35.0]. However, variable outcome reporting and inconsistent diagnostic criteria limited definitive conclusions.</div><div>The current literature on post-ORIF mobilisation is heterogeneous. Our meta-analysis demonstrated wide variability in outcomes across different regimens, with overlapping confidence intervals across most summary estimates. A definitive, multi-centre RCT comparing time to mobilisation post-ORIF, including comprehensive outcome reporting and cost-effectiveness analysis, is warranted to inform clinical practice.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 53-61"},"PeriodicalIF":2.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single modality indocyanine green is feasible for sentinel node detection in head and neck cutaneous melanoma: A prospective cohort study","authors":"Rini Vyas,&nbsp;Christopher Jones,&nbsp;Aenone Harper Machin","doi":"10.1016/j.bjps.2025.05.002","DOIUrl":"10.1016/j.bjps.2025.05.002","url":null,"abstract":"<div><div>Dual modality sentinel lymph node biopsy (SLNB) techniques are most commonly used in melanoma surgery, based on radiocolloid lymphoscintigraphy with either blue dye or indocyanine green (ICG) dye. No studies to date have analysed the use of ICG alone. This study examined the feasibility of ICG as a single modality for detecting sentinel nodes in cutaneous head and neck melanomas. A prospective cohort study was performed of all consecutive cutaneous head and neck melanomas patients between July 2023 and November 2024 undergoing SLNB at a supraregional skin cancer centre in the U.K. Three cohorts were formed: group A (ICG-only); group B (ICG and radiocolloid); and group C (radiocolloid and blue dye). 182 nodes were obtained from 67 patients. Where each technique was utilised, 100% of nodes were detected by ICG; 85% by radiocolloid; and 80% by blue dye. Radiocolloid failed to detect any nodes in three patients, and blue dye failed in four patients. In group B, ICG detected significantly more nodes than radiocolloid (<em>p</em>=0.0004); in group C, there was no difference between radiocolloid and blue dye (<em>p</em>=0.149). Twelve sentinel nodes were positive for melanoma: 100% were ICG positive, 88.9% were radiocolloid positive and 50% were blue dye positive. Single modality ICG is a feasible technique, with nodal detection and metastases detection rates comparable to dual modality. As an intraoperative surgeon-led technique, ICG-alone negates the need for preoperative lymphoscintigraphy with its associated radiation risk and nuclear medicine resource requirements.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 19-26"},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of axon count measurement and reporting for nerve transfers in the upper extremity","authors":"Mauro Maniglio ,&nbsp;Nicholas Haydon ,&nbsp;Simon Roner ,&nbsp;Heather L. Baltzer","doi":"10.1016/j.bjps.2025.05.003","DOIUrl":"10.1016/j.bjps.2025.05.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Axon counts in the literature vary by source and method, and no single source summarizes all brachial plexus nerves. This review aims to compile these counts in one article and assess comparability across studies.</div></div><div><h3>Methods</h3><div>A systematic review was conducted in November 2023, according to the PRISMA guidelines. Four databases were assessed using different variations of the terms \"nerve axon count* AND “upper extremity\". 539 articles were found and screened, and after full text assessment of the pre-selected articles, 54 articles were finally retained. For these articles, the axon counts, SD, and ranges were collected for all upper extremities’ nerves. If more than one article counted the axons of a specific nerve and if the difference between the counts was less than 100%, an average count was calculated.</div></div><div><h3>Results</h3><div>In the 54 articles a total of 56 nerves were assessed. Axon counts of 18 nerves were done only in a single study. In the comparison between the averages in between studies, in 20 nerves the difference excided 100% between the highest and lowest value. For 16 nerves a metanalysis could been performed and presented in the article.</div></div><div><h3>Conclusions</h3><div>Our study revealed enormous differences in axon counts across various studies, reaching up to a factor of 87 between the averages from one study to another. Additionally, the quality of the methods of these studies varies, particularly since axon count is frequently reported as a secondary or tertiary outcome. This insight cautions surgeons against using axon counts from studies with differing methodologies to plan nerve transfers.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 27-34"},"PeriodicalIF":2.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a deep ocular prosthesis socket using a concave bowl-shaped composite graft from the conchal cymba","authors":"Kazuhiro Tsunekawa,&nbsp;Shunsuke Yuzuriha","doi":"10.1016/j.bjps.2025.04.048","DOIUrl":"10.1016/j.bjps.2025.04.048","url":null,"abstract":"<div><h3>Background</h3><div>A deep socket is needed to wear an ocular prosthesis stably in patients with anophthalmia, hypophthalmia, or post-inflammatory fornix adhesions. This report introduces the novel approach of reconstructing a deep fornix using a composite graft from the conchal cymba.</div></div><div><h3>Methods</h3><div>Four patients who underwent construction of an inferior fornix by means of a composite graft obtained from the conchal cymba at Shinshu University Hospital between 2004 and 2024 were retrospectively studied. We analyzed graft size, postoperative outcomes, and complications.</div></div><div><h3>Operative technique</h3><div>A composite graft from the conchal cymba was harvested in patients unable to wear an ocular prosthesis. The shallow inferior fornix was incised horizontally, and a vestibule for the composite graft was created by blunt dissection, taking care not to damage the septum. We drilled square holes of 1 × 1 mm into the cartilage side of the composite graft, which was then transplanted into the space created in the fornix and fixed with gauze.</div></div><div><h3>Results</h3><div>The composite graft survived in all 4 patients who underwent reconstruction of the inferior fornix using this technique. All patients were able to wear an ocular prosthesis stably and reported satisfaction with their aesthetic improvement at 6–27 months of follow-up. No major procedure-related adverse events were recorded.</div></div><div><h3>Conclusions</h3><div>A deep concave vestibule was constructed in a single operation using a bowl-shaped composite graft obtained from the conchal cymba. This novel method may enable ocular prosthesis fitting by constructing a deep and stable socket.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 125-130"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144105199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter comments on \"A six-year retrospective study of patient outcomes following involved or close margin basal cell carcinoma excision\" methodology clarification for better clinical application","authors":"Ferruccio Paganini,&nbsp;Sara Matarazzo,&nbsp;Luigi Valdatta,&nbsp;Beatrice Corsini","doi":"10.1016/j.bjps.2025.03.063","DOIUrl":"10.1016/j.bjps.2025.03.063","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 444-445"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter comments on: “A nationwide analysis of the association between parental age and incidence of cleft lip/palate”","authors":"Georgios Karamitros,&nbsp;Michael P. Grant,&nbsp;Gregory A. Lamaris","doi":"10.1016/j.bjps.2025.03.062","DOIUrl":"10.1016/j.bjps.2025.03.062","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"106 ","pages":"Pages 9-10"},"PeriodicalIF":2.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}